Intraoperative Narrow‐Band Imaging Predicts Invasion Depth in Gallbladder Cancer

ABSTRACT Background/Purpose Accurate assessment of tumor invasion depth is essential for determining the surgical strategy for gallbladder cancer; however, preoperative assessment remains challenging. This study assessed the utility of intraoperative narrow‐band imaging (NBI) of the gallbladder serosal surface for estimating tumor invasion depth. Methods Thirty‐nine patients with suspected gallbladder cancer underwent intraoperative observation of the gallbladder serosa using NBI. The NBI findings were classified based on vascular irregularities and correlated with postoperative histopathological data. Results Among the 39 patients, 26 (66.7%) were diagnosed with gallbladder cancer. All patients with positive NBI ( n = 14) were pathologically confirmed to have gallbladder cancer. Positive NBI was significantly associated with ≥ T2 invasion and increased microvasculature in the subserosal layer ( p < 0.001), as well as with lymphatic invasion ( p < 0.001). Diagnostic sensitivities for ≥ T2 invasion were 79.5% for intraoperative NBI, 69.4% for plane CT, and 63.0% for EUS. Conclusions Intraoperative NBI may be useful for evaluating tumor depth and lymphatic involvement in patients suspected to have gallbladder cancer, which can support intraoperative surgical decision‐making.